4,384 results match your criteria Adrenal Disease and Pregnancy


No evidence of vertical transmission of SARS-CoV-2 after induction of labour in an immune-suppressed SARS-CoV-2-positive patient.

BMJ Case Rep 2020 Jun 30;13(6). Epub 2020 Jun 30.

Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands

We present a case of a 38+1 weeks pregnant patient (G1P0) with a proven COVID-19 infection, who was planned for induction of labour because of pre-existent hypertension, systemic lupus erythematosus, respiratory problem of coughing and mild dyspnoea without fever during the COVID-19 pandemic in March 2020. To estimate the risk of vertical transmission of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) during labour and delivery, we collected oropharyngeal, vaginal, urinary, placental and neonatal PCRs for SARS-CoV-2 during the period of admission. All PCRs, except for the oropharyngeal, were negative and vertical transmission was not observed. Read More

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http://dx.doi.org/10.1136/bcr-2020-235581DOI Listing

Treatment of primary hyperaldosteronism.

Med Clin (Barc) 2020 Jun 22. Epub 2020 Jun 22.

Unidad de Neuroendocrinología, Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address:

Primary aldosteronism is associated with higher cardiovascular and renal morbidity and mortality than essential hypertension in age- and sex-matched patients with the same degree of blood pressure elevation. Therefore, it is essential to establish a specific treatment to avoid the deleterious effects of aldosterone excess. Although adrenalectomy is generally considered the treatment of choice in cases of primary aldosteronism due to unilateral disease, several aspects and circumstances should be taken into account that may make medical treatment more appropriate. Read More

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http://dx.doi.org/10.1016/j.medcli.2020.04.029DOI Listing

Stillbirth in women with diabetes: a retrospective analysis of fetal autopsy reports.

J Matern Fetal Neonatal Med 2020 Jun 21:1-8. Epub 2020 Jun 21.

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Rochester Medical Center, Rochester, NY, USA.

Diabetes in pregnancy is associated with an increased rate of stillbirth. There are a wide variety of factors that have been implicated including placental insufficiency, hypoxia, hyperinsulinemia and impaired cardiac function. Furthermore, there is evidence that diabetic pregnancies have an increased rate of fetal cardiomyopathy as compared to non-diabetic pregnancies. Read More

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http://dx.doi.org/10.1080/14767058.2020.1779213DOI Listing

Consequences of maternal psychological stress during pregnancy for the risk of asthma in the offspring.

Scand J Immunol 2020 Jun 15:e12919. Epub 2020 Jun 15.

Department of Medicine, University of Cambridge, Cambridge.

Asthma is a common lung condition that makes breathing difficult through the inflammation and constriction of the lung airways. Epidemiological evidence supports the presence of a positive association between prenatal maternal psychological stress (PMPS) and asthma in the offspring, suggesting the disease may have developmental origins. T-helper 2 (Th2) cells are a major subtype of T-helper cells, producing Th2 cytokines, which may be the main drivers of asthma symptoms. Read More

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http://dx.doi.org/10.1111/sji.12919DOI Listing

Psycho-neuro-endocrino-immunologic issues in multiple sclerosis: a critical review of clinical and therapeutic implications.

Hormones (Athens) 2020 Jun 1. Epub 2020 Jun 1.

University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Multiple sclerosis (MS) is a multifactorial, chronic, immune-mediated, and neurodegenerative disease, having a well-known hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Several hormones have a great impact in the immune dysregulation, psychology, and cognitive status of patients with MS, as also in the fertility and response to treatment. In this comprehensive review, as an introduction, we mention basic data concerning MS: epidemiology, genetics, immunogenetics, epigenetics, pathophysiology, and neuroimmunology. Read More

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http://dx.doi.org/10.1007/s42000-020-00197-8DOI Listing

Pregnancy during the course of Cushing's syndrome: a case report and literature review.

Endocrinol Diabetes Metab Case Rep 2020 Apr 12;2020. Epub 2020 Apr 12.

Division of Endocrinology, Guillermo Almenara Irigoyen National Hospital, Lima, Peru.

Summary: Cushing's syndrome is an endocrine disorder that causes anovulatory infertility secondary to hypercortisolism; therefore, pregnancy rarely occurs during its course. We present the case of a 24-year-old, 16-week pregnant female with a 10-month history of unintentional weight gain, dorsal gibbus, nonpruritic comedones, hirsutism and hair loss. Initial biochemical, hormonal and ultrasound investigations revealed hypokalemia, increased nocturnal cortisolemia and a right adrenal mass. Read More

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http://dx.doi.org/10.1530/EDM-20-0022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159255PMC

Fertility and pregnancy in women with primary adrenal insufficiency.

Endocrine 2020 May 29. Epub 2020 May 29.

Section of Internal Medicine and Endocrinological and Metabolic Sciences, Department of Medicine, University of Perugia, 06129, Perugia, Italy.

Primary adrenal insufficiency (PAI) occurs in ~1/5000-1/7000 individuals and is in most cases caused by autoimmune Addison's disease (AAD). Around 10-20% of women with AAD develop premature ovarian insufficiency (POI) before the age of 40 years. 21-Hydroxylase autoantibodies (21OHAb) are the best single immune marker to classify AAD among PAI patients and autoimmune POI in hypergonadotropic hypogonadic women. Read More

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http://dx.doi.org/10.1007/s12020-020-02343-zDOI Listing

Stress, strain, and pregnancy outcome in postpartum cows.

Authors:
Matthew C Lucy

Anim Reprod 2019 Oct 23;16(3):455-464. Epub 2019 Oct 23.

Division of Animal Sciences, University of Missouri, Animal Science Research Center, Columbia, MO, USA.

Stress affects the productivity and fertility of cattle. Stress causes strain and individual animals experience different amounts of strain in response to the same amount of stress. The amount of strain determines the impact of stress on fertility. Read More

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http://dx.doi.org/10.21451/1984-3143-AR2019-0063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234163PMC
October 2019

Adrenalectomy during pregnancy: A 15-year experience at a tertiary referral center.

Surgery 2020 May 17. Epub 2020 May 17.

Department of Digestive, Hepato-biliary and Endocrine Surgery, Referral Center for Rare Adrenal Diseases, Cochin Hospital, APHP, Paris, France; Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France; INSERM Unité 1016, Centre National de la Recherche Scientifique Unité Mixte de Recherche 8104, Institut Cochin, Paris, France.

Background: Adrenal lesions diagnosed during pregnancy remain rare, and their management is challenging because of maternal physiologic modifications, restricted imaging investigations, and contraindications to several treatments. Surgical issues of adrenalectomy during pregnancy and consequences on perinatal outcomes are poorly described. We therefore aimed to report maternal and fetal outcomes after adrenalectomy during pregnancy. Read More

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http://dx.doi.org/10.1016/j.surg.2020.03.019DOI Listing

Current Management and Outcome of Pregnancies in Women With Adrenal Insufficiency: Experience from a Multicenter Survey.

J Clin Endocrinol Metab 2020 Aug;105(8)

Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland.

Context: Appropriate management of adrenal insufficiency (AI) in pregnancy can be challenging due to the rarity of the disease and lack of evidence-based recommendations to guide glucocorticoid and mineralocorticoid dosage adjustment.

Objective: Multicenter survey on current clinical approaches in managing AI during pregnancy.

Design: Retrospective anonymized data collection from 19 international centers from 2013 to 2019. Read More

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http://dx.doi.org/10.1210/clinem/dgaa266DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320831PMC

COVID-19 infection during pregnancy: fetus as a patient deserves more attention.

J Perinat Med 2020 Jun;48(5):438-440

Department of Obstetrics and Gynecology, Fetom ternal Medical Center, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 2, 00290 Helsinki, Finland.

The novel coronavirus disease 2019 (COVID-19) pandemic is causing concern also for the management and outcome of COVID-19-positive pregnant women and their offspring, as reported cases are rare. Current evidence suggests the association of COVID-19 infection in pregnancy with both severe maternal morbidity requiring intensive care and perinatal complications (preterm birth with consequent neonatal morbidity and even perinatal death). Most of the reported cases focused specifically on the maternal outcomes and possible vertical transmission, but less attention has been paid to fetus as a patient in such pregnancies. Read More

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http://dx.doi.org/10.1515/jpm-2020-0181DOI Listing

Alterations in endogenous progesterone metabolism associated with spontaneous very preterm delivery.

Hum Reprod Open 2020 6;2020(2):hoaa007. Epub 2020 Apr 6.

Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

Study Question: Do maternal serum levels of progesterone metabolites early in pregnancy correspond to an increased risk for very preterm delivery prior to 32 weeks?

Summary Answer: Maternal serum levels of 11-deoxycorticosterone (DOC) measured during the late first trimester or early second trimester correlate with an increased risk for preterm delivery prior to 32 weeks, and the correlation becomes stronger when the ratio of DOC to 16-alpha-hydroxyprogesterone was measured.

What Is Known Already: Progesterone is a pro-gestational steroid hormone that has been shown to decrease the risk of preterm birth in some pregnant women. Progesterone is metabolized by the body into various metabolites including members of the mineralocorticoid and glucocorticoid families. Read More

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http://dx.doi.org/10.1093/hropen/hoaa007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7133115PMC

Middle East respiratory syndrome.

Lancet 2020 03 4;395(10229):1063-1077. Epub 2020 Mar 4.

Department of Infection, Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, London, UK; National Institute for Health Research Biomedical Research Centre, University College London Hospitals, London, UK. Electronic address:

The Middle East respiratory syndrome coronavirus (MERS-CoV) is a lethal zoonotic pathogen that was first identified in humans in Saudi Arabia and Jordan in 2012. Intermittent sporadic cases, community clusters, and nosocomial outbreaks of MERS-CoV continue to occur. Between April 2012 and December 2019, 2499 laboratory-confirmed cases of MERS-CoV infection, including 858 deaths (34·3% mortality) were reported from 27 countries to WHO, the majority of which were reported by Saudi Arabia (2106 cases, 780 deaths). Read More

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http://dx.doi.org/10.1016/S0140-6736(19)33221-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155742PMC

Implications of early life stress on fetal metabolic programming of schizophrenia: A focus on epiphenomena underlying morbidity and early mortality.

Prog Neuropsychopharmacol Biol Psychiatry 2020 Jul 4;101:109910. Epub 2020 Mar 4.

Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland; School of Medicine, Trinity College Dublin, Dublin, Ireland.

The fetal origin of adult disease hypothesis postulates that a stressful in utero environment can have deleterious consequences on fetal programming, potentially leading to chronic disease in later life. Factors known to impact fetal programming include the timing, intensity, duration and nature of the external stressor during pregnancy. As such, dynamic modulation of fetal programming is heavily involved in shaping health throughout the life course, possibly by influencing metabolic parameters including insulin action, hypothalamic-pituitary-adrenal activity and immune function. Read More

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http://dx.doi.org/10.1016/j.pnpbp.2020.109910DOI Listing

Sleep disordered breathing in pregnancy: A review of the pathophysiology of adverse pregnancy outcomes.

Acta Physiol (Oxf) 2020 Jun 10;229(2):e13458. Epub 2020 Mar 10.

Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, Edinburgh, United Kingdom.

Sleep disordered breathing (SDB) is a common obesity-related co-morbidity with strong associations to cardiometabolic disease. The risk of SDB is increased during pregnancy, particularly among obese pregnant women. Accumulating evidence suggests that an association exists between maternal SDB and the development of adverse pregnancy outcomes, particularly gestational diabetes and hypertensive disorders of pregnancy. Read More

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http://dx.doi.org/10.1111/apha.13458DOI Listing

Chronic psychosocial stress during pregnancy affects maternal behavior and neuroendocrine function and modulates hypothalamic CRH and nuclear steroid receptor expression.

Transl Psychiatry 2020 Jan 16;10(1). Epub 2020 Jan 16.

Center for the Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Postpartum depression (PPD) affects up to 20% of mothers and has negative consequences for both mother and child. Although exposure to psychosocial stress during pregnancy and abnormalities in the hypothalamic pituitary adrenal (HPA) axis have been linked to PPD, molecular changes in the brain that contribute to this disease remain unknown. This study utilized a novel chronic psychosocial stress paradigm during pregnancy (CGS) to investigate the effects of psychosocial stress on maternal behavior, neuroendocrine function, and gene expression changes in molecular regulators of the HPA axis in the early postpartum period. Read More

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http://dx.doi.org/10.1038/s41398-020-0704-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026416PMC
January 2020

Normal size of the fetal adrenal gland on prenatal magnetic resonance imaging.

Pediatr Radiol 2020 May 14;50(6):840-847. Epub 2020 Feb 14.

Department of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, USA.

Background: The adrenal gland plays a vital role in fetal growth. Many disease states such as congenital adrenal hyperplasia, hemorrhage and tumors can lead to morphological changes in the gland. Ultrasound measurements of normal adrenal sizes in the fetus reported in the literature have shown a trend of increasing size with gestational age. Read More

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http://dx.doi.org/10.1007/s00247-020-04629-wDOI Listing

No Evidence for Enhancement of Spatial Ability with Elevated Prenatal Androgen Exposure in Congenital Adrenal Hyperplasia: A Meta-Analysis.

Arch Sex Behav 2020 02 12;49(2):395-411. Epub 2020 Feb 12.

Department of Psychology, University of Cambridge, Cambridge, UK.

Spatial abilities contribute to life and occupational competencies, and certain spatial skills differ, on average, between males and females, typically favoring males when differences occur. Factors contributing to spatial skills could include prenatal as well as experiential/cultural influences, with biological and social influences likely interacting and difficult to disentangle. This meta-analysis examined the potential influence of prenatal androgen exposure on spatial skill by examining studies of patients with congenital adrenal hyperplasia (CAH). Read More

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http://dx.doi.org/10.1007/s10508-020-01645-7DOI Listing
February 2020

Spontaneous adrenal hemorrhage and preeclampsia: A case report.

Saudi J Anaesth 2020 Jan-Mar;14(1):117-119. Epub 2020 Jan 6.

Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Spontaneous Adrenal Hemorrhage is a rare disease. It's one of the rare causes of abdominal pain late in pregnancy. I present a case with near term Spontaneous Adrenal Hemorrhage and concurrent severe preeclampsia, aiming to address the anesthetic considerations and management of such challenging presentation. Read More

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http://dx.doi.org/10.4103/sja.SJA_550_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970351PMC
January 2020

[Ultrasound diagnosis of fetal adrenal hemorrhage].

Orv Hetil 2019 Dec;160(52):2073-2078

Szülészeti és Nőgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Baross u. 27., 1088.

The confirmed incidence of new-onset adrenal gland hemorrhage has increased with the development of ultrasound diagnostics in recent years. Intrauterine developed cases are rarely recognized. Differential diagnosis of cystic lesions of the adrenal gland is often only possible after birth. Read More

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http://dx.doi.org/10.1556/650.2019.31578DOI Listing
December 2019

Bartter syndrome: An infrequent tubulopathy of prenatal onset.

Rev Chil Pediatr 2019 Aug;90(4):437-442

Unidad de Gestión Clínica del Niño, Hospital Padre Hurtado, Chile.

Introduction: Bartter syndrome (BS) is a rare inherited tubulopathy that has two presentation forms, the first one is a severe form of antenatal onset (neonatal Bartter) and the second one is a later on set form during the first years of life (classic Bartter). In the antenatal form, it manifests with fetal polyuria, polyhydramnios of early and severe onset, premature delivery, and intrauterine growth restriction. In the postnatal stage, it presents recurrent episodes of dehydration and electrolyte im balance that can compromise the survival of the patient. Read More

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http://dx.doi.org/10.32641/rchped.v90i4.932DOI Listing

Neonate Death Due to Marijuana Toxicity to the Liver and Adrenals.

Am J Case Rep 2019 Dec 15;20:1874-1878. Epub 2019 Dec 15.

Champaign County Coroner's Office, Urbana, IL, USA.

BACKGROUND Marijuana is the considered the most widely available and used drug across the world. Up to this time, there have been no reports of human death directly caused by acute marijuana toxicity in adults, fetuses, or newborn neonates. CASE REPORT We report a death of an 11-day-old white female neonate due to acute marijuana toxicity. Read More

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http://dx.doi.org/10.12659/AJCR.919545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930694PMC
December 2019

Monozygotic twins discordant for congenital adrenal hyperplasia due to mosaicism.

Eur J Endocrinol 2020 Feb;182(2):K7-K13

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.

Introduction: Genotype-phenotype discordance occurs occasionally in congenital adrenal hyperplasia (CAH). Its causes are largely unknown. We describe a case of monochorionic, diamniotic twins with discordant clinical presentations of CAH, and show evidence for this being due to mosaicism resulting from a postzygotic full gene deletion of CYP21A2 prior to twinning. Read More

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http://dx.doi.org/10.1530/EJE-19-0249DOI Listing
February 2020

Addison's disease in pregnancy: Case report, management, and review of the literature.

J Neonatal Perinatal Med 2020 ;13(2):275-278

Department of Obstetrics and Gynecology, George Washington University, Washington, DC.

Background: Addison's disease is an uncommon condition encountered during pregnancy; however, pregnant patients with Addison's disease are at higher risk for multiple pregnancy related complications. Treatment during pregnancy involves steroid replacement therapy.

Case Report: A 34-year-old previously healthy G2P1001 presented with lethargy, skin hyperpigmentation, polyuria, and salt craving. Read More

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http://dx.doi.org/10.3233/NPM-190231DOI Listing
January 2020

[Secondary hypertension in women].

Presse Med 2019 Nov 13;48(11 Pt 1):1265-1268. Epub 2019 Nov 13.

AP-HP, hôpital européen Georges-Pompidou, unité d'hypertension artérielle, 75015 Paris, France; Université de Paris, Paris-Centre de recherche cardiovasculaire, Inserm UMR-970, 75015 Paris, France; Université de Paris, hôpital européen Georges-Pompidou, Inserm, CIC1418, 75015 Paris, France.

The two main non-iatrogenic causes of secondary hypertension in women of childbearing age are primary aldosteronism and renal fibromuscular dysplasia. It is recommended to look for a secondary hypertension in women who remain hypertensive three months after pregnancy, in patients under 40 years of age or in patients with a grade 3 HTN (BP≥180/110mm Hg) (Professional agreement). It is suggested that the initial assessment of a secondary HTN in women is performed by a HTN specialist; it will include an assessment of renin and aldosterone concentrations and an angio-CT of the renal arteries (or angio-MRI if contraindicated) (Grade C - Class 2). Read More

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http://dx.doi.org/10.1016/j.lpm.2019.07.029DOI Listing
November 2019

Assisted Reproduction in Congenital Adrenal Hyperplasia.

Front Endocrinol (Lausanne) 2019 23;10:723. Epub 2019 Oct 23.

Unit of Endocrinology, Diabetes Mellitus and Metabolism, 2nd Department of Obstetrics and Gynecology, Medical School, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Congenital Adrenal Hyperplasia (CAH) is a group of autosomal recessive disorders characterized by defects of adrenal steroidogenesis due to mutations in one of the following enzymes: 21-hydroxylase (21OH), 11β-hydroxylase (11βOH), 17α-hydroxylase (17OH; also known as 17, 20-lyase), 3β hydroxysteroid dehydrogenase type 2 (3βHSD2), steroidogenic acute regulatory protein (StAR), P450 cholesterol side-chain cleavage (P450scc), and P450 oxidoreductase (POR). More than 95% of congenital adrenal hyperplasia cases are due to mutations in CYP21A2, the gene encoding the adrenal steroid 21-hydroxylase enzyme (P450c21). This work focuses on this type of CAH given that it is the most frequent one. Read More

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http://dx.doi.org/10.3389/fendo.2019.00723DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6819309PMC
October 2019

The reproductive stress hypothesis.

Reproduction 2019 12;158(6):R209-R218

Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Hunan Agricultural University, Changsha, People's Republic of China.

In this paper, we propose the reproductive stress hypothesis that describes the pregnant females response to reproductive events based upon the activation of the hypothalamic-pituitary-adrenal axis and sympathetic adrenomedullary system. The main components of the reproductive stress hypothesis can be summarized as follows: (1) events unique to reproduction including empathema, pregnancy, parturition and lactation cause non-specific responses in females, called active reproductive stress; (2) the fetus is a special stressor for pregnant females where endocrine hormones, including corticotropin-releasing hormones and fetal glucocorticoids secreted by the fetus and placenta, enter the maternal circulatory system, leading to another stress response referred to as passive reproductive stress and (3) response to uterine tension and intrauterine infection is the third type of stress, called fetal intrauterine stress. Appropriate reproductive stress is a crucial prerequisite in normal reproductive processes. Read More

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http://dx.doi.org/10.1530/REP-18-0592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892456PMC
December 2019

Intranasal corticosteroids for non-allergic rhinitis.

Cochrane Database Syst Rev 2019 11 2;2019(11). Epub 2019 Nov 2.

Academic Medical Centre, Department of Otorhinolaryngology, Meibergdreef 9, A2-234, 1105 Az, Amsterdam, Netherlands.

Background: Non-allergic rhinitis is defined as dysfunction and non-infectious inflammation of the nasal mucosa that is caused by provoking agents other than allergens or microbes. It is common, with an estimated prevalence of around 10% to 20%. Patients experience symptoms of nasal obstruction, anterior rhinorrhoea/post-nasal drip and sneezing. Read More

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http://dx.doi.org/10.1002/14651858.CD010592.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824914PMC
November 2019

Rivaroxaban Related Bilateral Adrenal Hemorrhage: A Rare Complications of Direct Oral Anticoagulants - A Case Reports.

Am J Case Rep 2019 Nov 2;20:1607-1611. Epub 2019 Nov 2.

Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ, USA.

BACKGROUND Adrenal hemorrhage is an uncommon and under-recognized disorder with a wide array of etiologies ranging from pregnancy to septic shock. It is one of the complications of anticoagulation therapy, including direct anticoagulant medications. CASE REPORT Here, we present a case of a 68-year-old female with recent right knee arthroplasty who was on rivaroxaban for deep vein thrombosis (DVT) prophylaxis presented to the emergency department (ED) for severe acute onset abdominal pain, computed tomography (CT) of abdomen and pelvis revealed possible left adrenal hemorrhage that was confirmed with magnetic resonance imaging (MRI). Read More

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http://dx.doi.org/10.12659/AJCR.917780DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849691PMC
November 2019

Prenatal and postnatal imaging techniques in the evaluation of disorders of sex development.

Semin Pediatr Surg 2019 Oct 24;28(5):150839. Epub 2019 Sep 24.

Division of Pediatric Radiology, Phoenix Children's Hospital, Phoenix, AZ, United States.

Imaging of the reproductive tract is challenging and requires a general knowledge of congenital variations in anatomy. The anatomy of the developing fetus, whether a male phenotype or female phenotype, is also a dynamic process with many changes occurring during gestation. Families may ask details about the genitalia during prenatal imaging and when variations in what is thought to be normal are present, further investigation is sometimes needed to make sense of what is seen. Read More

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http://dx.doi.org/10.1016/j.sempedsurg.2019.150839DOI Listing
October 2019
1 Read

Evaluation and Management of Endocrine Hypertension During Pregnancy.

Endocrinol Metab Clin North Am 2019 12 19;48(4):829-842. Epub 2019 Sep 19.

Endocrinology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, I-00168, Rome, Italy. Electronic address:

Hypertension is a common clinical complication in pregnancy, representing possible short-term and long-term risks of complications for both mothers and babies. Even if in a majority of cases hypertension is essential, possible secondary causes, which can be related to endocrine disorders, must be detected and correctly managed. This review focuses on the evaluation and the management of primary hyperaldosteronism, Cushing syndrome, and pheochromocytoma in pregnancy. Read More

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http://dx.doi.org/10.1016/j.ecl.2019.08.011DOI Listing
December 2019
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In-utero stress and mode of conception: impact on regulation of imprinted genes, fetal development and future health.

Hum Reprod Update 2019 11;25(6):777-801

First Department of Obstetrics and Gynecology, Laboratory of Genetics, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Ring Road, Nea Efkarpia, 56403 Thessaloniki, Greece.

Background: Genomic imprinting is an epigenetic gene regulatory mechanism; disruption of this process during early embryonic development can have major consequences on both fetal and placental development. The periconceptional period and intrauterine life are crucial for determining long-term susceptibility to diseases. Treatments and procedures in assisted reproductive technologies (ART) and adverse in-utero environments may modify the methylation levels of genomic imprinting regions, including insulin-like growth factor 2 (IGF2)/H19, mesoderm-specific transcript (MEST), and paternally expressed gene 10 (PEG10), affecting the development of the fetus. Read More

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http://dx.doi.org/10.1093/humupd/dmz025DOI Listing
November 2019
1 Read

Prenatal glucocorticoids exposure and fetal adrenal developmental programming.

Toxicology 2019 12 12;428:152308. Epub 2019 Oct 12.

Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China. Electronic address:

Clinically, we apply synthetic glucocorticoids to treat fetal and maternal diseases, such as premature labor and autoimmune diseases. Although its clinical efficacy is positive, the fetus will be exposed to exogenous synthetic glucocorticoids. Prenatal adverse environments (such as xenobiotics exposure, malnutrition, infection, hypoxia and stress) can cause fetuses overexposure to excessive endogenous maternal glucocorticoids. Read More

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http://dx.doi.org/10.1016/j.tox.2019.152308DOI Listing
December 2019
1 Read

The Pharmacokinetics of Vitamin C.

Nutrients 2019 Oct 9;11(10). Epub 2019 Oct 9.

Faculty of Health and Medical Sciences, Department of Veterinary and Animal Sciences, University of Copenhagen, DK-1870 Frederiksberg C, Denmark.

The pharmacokinetics of vitamin C (vitC) is indeed complex. Regulated primarily by a family of saturable sodium dependent vitC transporters (SVCTs), the absorption and elimination are highly dose-dependent. Moreover, the tissue specific expression levels and subtypes of these SVCTs result in a compartmentalized distribution pattern with a diverse range of organ concentrations of vitC at homeostasis ranging from about 0. Read More

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http://dx.doi.org/10.3390/nu11102412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835439PMC
October 2019
1 Read

PREPARE: protocol for a stepped wedge trial to evaluate whether a risk stratification model can reduce preterm deliveries among women with suspected or confirmed preterm pre-eclampsia.

BMC Pregnancy Childbirth 2019 Oct 7;19(1):343. Epub 2019 Oct 7.

Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA, USA.

Background: Preeclampsia (PE) is a major cause of short and long-term morbidity for affected infants, including consequences of fetal growth restriction and iatrogenic prematurity. In Brazil, this is a special problem as PE accounts for 18% of preterm births (PTB). In the PREPARE (Prematurity REduction by Pre-eclampsia cARE) study, we will test a novel system of integrated care based on risk stratification and knowledge transfer, to safely reduce PTB. Read More

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http://dx.doi.org/10.1186/s12884-019-2445-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781345PMC
October 2019
2 Reads

[Application of Shared Decision Making on Birth Choice in a Primigravida Woman With Congenital Adrenal Hyperplasia].

Hu Li Za Zhi 2019 Oct;66(5):80-85

MSN, RN, Department of Nursing, MacKay Memorial Hospital, Taiwan, ROC.

Shared decision making was used by a primipara with congenital adrenal hyperplasia to make decisions related to her delivery plans and process. The four components of the holistic nursing assessment process (physical, mental, social and spiritual) were conducted by the author from January 9th, 2018 to April 8th, 2018. The major concerns of the subject were anxiety and conflicts related to medical decision making for her health problems. Read More

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http://dx.doi.org/10.6224/JN.201910_66(5).11DOI Listing
October 2019
2 Reads

Evaluating the effects on steroidogenesis of estragole and trans-anethole in a feto-placental co-culture model.

Mol Cell Endocrinol 2019 12 16;498:110583. Epub 2019 Sep 16.

INRS - Centre Armand-Frappier Santé Biotechnologie, Laval, QC, H7V 1B7, Canada. Electronic address:

In this study, we determined whether estragole and its isomer trans-anethole interfered with feto-placental steroidogenesis in a human co-culture model composed of fetal-like adrenocortical (H295R) and placental trophoblast-like (BeWo) cells. Estragole and trans-anethole are considered the biologically active compounds within basil and fennel seed essential oils, respectively. After a 24 h exposure of the co-culture to 2. Read More

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http://dx.doi.org/10.1016/j.mce.2019.110583DOI Listing
December 2019

Pheochromocytoma.

Endocr Regul 2019 Jul;53(3):191-212

Third Department of Surgery, Attikon University Hospital, Medical School of Athens, Athens, Greece.

Pheochromocytomas are rare tumors originating in the adrenal medulla. They may be sporadic or in the context of a hereditary syndrome. A considerable number of pheochromocytomas carry germline or somatic gene mutations, which are inherited in the autosomal dominant way. Read More

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http://dx.doi.org/10.2478/enr-2019-0020DOI Listing
July 2019
2 Reads

THE MULTIFARIOUS CUSHING'S - LESSONS FROM A CASE SERIES.

Acta Endocrinol (Buchar) 2019 Apr-Jun;15(2):261-269

"C.I.Parhon" National Institute of Endocrinology, Bucharest, Romania.

Endogenous Cushing's syndrome is rare, with an incidence of 0.7-2.4 per a million people a year. Read More

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http://dx.doi.org/10.4183/aeb.2019.261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711653PMC
September 2019
1 Read

Influence of hormones on the immunotolerogenic molecule HLA-G: a cross-sectional study in patients with congenital adrenal hyperplasia.

Eur J Endocrinol 2019 Nov;181(5):481-488

Department of Pharmacology, Sorbonne Université, INSERM CIC Paris-Est, UNICO AP-HP.6 Cardio-Oncology Program, Pitié-Salpêtrière Hospital, Paris, France.

Background: HLA-G is an immune checkpoint molecule, naturally expressed during pregnancy, playing a critical role in the tolerance of the fetal semi-allograft from the maternal immune system. While HLA-G expression levels are associated with progesterone, the influence of other hormones is still unclear. Congenital adrenal hyperplasia (CAH) represents an adequate model to study the hormonal influence on biomarkers as it leads to impaired cortisol biosynthesis and increased progesterone and androgens production due to 21-hydroxylase enzyme deficiency. Read More

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http://dx.doi.org/10.1530/EJE-19-0379DOI Listing
November 2019
3 Reads

Long-term safety and efficacy of rituximab in 248 adults with immune thrombocytopenia: Results at 5 years from the French prospective registry ITP-ritux.

Am J Hematol 2019 12 8;94(12):1314-1324. Epub 2019 Oct 8.

Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris Est Créteil, Créteil, France.

Rituximab is a second-line option in adults with immune thrombocytopenia (ITP), but the estimated 5-year response rate, only based on pooled retrospective data, is about 20%, and no studies have focused on long-term safety. We conducted a prospective multicenter registry of 248 adults with ITP treated with rituximab with 5 years of follow-up to assess its long-term safety and efficacy. The median follow-up was 68. Read More

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http://dx.doi.org/10.1002/ajh.25632DOI Listing
December 2019
9 Reads

Fetal programming of adrenal PNMT and hypertension by glucocorticoids in WKY rats is dose and sex-dependent.

PLoS One 2019 4;14(9):e0221719. Epub 2019 Sep 4.

Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, Ontario, Canada.

Biochemical changes in utero may alter normal fetal development, resulting in disease later in life, a phenomenon known as fetal programming. Recent epidemiological studies link fetal programming to negative health outcomes, such as low birth weight and hypertension in adulthood. Here, we used a WKY rat model and studied the molecular changes triggered by prenatal glucocorticoid (GC) exposure on the development of hypertension, and on the regulation of phenylethanolamine N-methyl transferase (PNMT), the enzyme responsible for biosynthesis of epinephrine, and a candidate gene linked to hypertension. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0221719PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726223PMC

Diverse Responses of Autoantibodies to the Angiotensin II Type 1 Receptor in Primary Aldosteronism.

Hypertension 2019 10 3;74(4):784-792. Epub 2019 Sep 3.

From the Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany (T.A.W., D.J., Y.Y., P.R., N.N., L.S., M.B., F.B., M.R.).

Primary aldosteronism is a common form of endocrine hypertension mainly caused by a unilateral aldosterone-producing adenoma (APA) or bilateral adrenal hyperplasia (BAH). AT1R-Abs (autoantibodies to the angiotensin II type 1 receptor) have been reported in patients with disorders associated with hypertension. Our objective was to assess AT1R-Ab levels in patients with primary aldosteronism (APA, n=40 and BAH, n=40) relative to patients with primary hypertension (n=40), preeclampsia (n=23), and normotensive individuals (n=25). Read More

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http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.13156DOI Listing
October 2019
2 Reads

Adrenal disorders in pregnancy, labour and postpartum - an overview.

J Obstet Gynaecol 2020 Aug 30;40(6):749-758. Epub 2019 Aug 30.

Department of Obstetrics and Gynaecology, Azra Naheed Medical College, Lahore, Pakistan.

Adrenal disorders may manifest during pregnancy for the first time, or present from before pregnancy as either undiagnosed or diagnosed and treated. They may present as hormonal hypofunction or hyperfunction, or with mass effects or other non-endocrine effects. Adrenal disorders such as Cushing's syndrome, Addison's disease, pheochromocytoma, primary hyper-aldosteronism and adreno-cortical carcinoma are rare in pregnancy. Read More

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http://dx.doi.org/10.1080/01443615.2019.1648395DOI Listing

Severe thrombocytopenia in pregnancy: a case series from west China.

Clin Exp Med 2019 Nov 28;19(4):495-503. Epub 2019 Aug 28.

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.

Thrombocytopenia is the second most common hematological disease during pregnancy and is mainly caused by gestational thrombocytopenia, immune thrombocytopenia, or preeclampsia/HELLP syndrome. This study aims to investigate the causes and pregnancy outcomes of thrombocytopenia in pregnancies with platelet counts below 50 × 10/L. We retrospectively analyzed the pregnancies diagnosed with severe thrombocytopenia at a tertiary care center in western China between January 2009 and December 2017. Read More

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http://dx.doi.org/10.1007/s10238-019-00575-6DOI Listing
November 2019
3 Reads

First trimester determination of fetal gender by ultrasonographic measurement of anogenital distance: A cross-sectional study.

Int J Reprod Biomed (Yazd) 2019 Jan 3;17(1). Epub 2019 Mar 3.

Departement of Pharmacology, School of Medicine, Tehran University of Medical Science, Tehran, Iran.

Background: In some patients with a family history of the gender-linked disease, determination of the fetal gender in the first trimester of pregnancy is of importance. In X-linked recessive inherited diseases, only the male embryos are involved, while in some conditions, such as congenital adrenal hyperplasia, female embryos are affected; hence early determination of fetal gender is important.

Objective: The aim of the current study was to predict the gender of the fetus based on the accurate measurement of the fetal anogenital distance (AGD) by ultrasound in the first trimester. Read More

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http://dx.doi.org/10.18502/ijrm.v17i1.3820DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6652156PMC
January 2019
1 Read

Transfer of embryos with positive results following preimplantation genetic testing for monogenic disorders (PGT-M): experience of two high-volume fertility clinics.

J Assist Reprod Genet 2019 Sep 29;36(9):1949-1955. Epub 2019 Jul 29.

ORM Fertility, 808 SW 15th Ave, Portland, OR, 97205, USA.

Purpose: To assess the experiences of two large fertility clinics in which embryos with positive results following preimplantation genetic testing for monogenic disorders (PGT-M) were transferred upon patient request, in order to explore the nature of the conditions for which these requests have been made and review ethical considerations.

Methods: Retrospective review of previous embryo transfers at the NYU Langone Fertility Center and ORM Fertility was performed. Embryo transfers prior to May 2019 in which embryo biopsy and PGT-M occurred were reviewed, and transferred embryos that were positive for a monogenic disorder (excluding autosomal recessive carriers) were identified. Read More

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http://dx.doi.org/10.1007/s10815-019-01538-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6730968PMC
September 2019
2 Reads

Pregnancy in Congenital Adrenal Hyperplasia.

Authors:
Nicole Reisch

Endocrinol Metab Clin North Am 2019 09;48(3):619-641

Medizinische Klinik IV, Department of Endocrinology, Klinikum der Universität München, Ziemssenstraße 1, München 80336, Germany. Electronic address:

Fertility rates in classic congenital adrenal hyperplasia caused by 21-hydroxylase deficiency are substantially decreased for various reasons, including hormonal, anatomic, psychosocial, and psychosexual causes. However, fecundity is comparable with the general population. Under optimal hormone replacement, the course and outcome of pregnancies is also good. Read More

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http://dx.doi.org/10.1016/j.ecl.2019.05.011DOI Listing
September 2019

Pheochromocytoma and Pregnancy.

Endocrinol Metab Clin North Am 2019 09 13;48(3):605-617. Epub 2019 Jun 13.

Department of Medicine III, Carl Gustav Carus University Medical Centre, Dresden, Germany; Institute of Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetcherstrasse 74, 01307 Dresden, Germany.

Pheochromocytoma during pregnancy, although rare, is a perilous condition. The wellbeing of mother and fetus are at stake if not diagnosed and treated antenatally and timely. The diagnosis is frequently overlooked because of the aspecific nature of signs and symptoms and confusion with pregnancy-related hypertension. Read More

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http://dx.doi.org/10.1016/j.ecl.2019.05.006DOI Listing
September 2019
2 Reads

[Differential diagnosis and minimally invasive surgery of an antenatal adrenal mass].

Rev Chil Pediatr 2019 Jun;90(3):321-327

Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile.

Introduction: Adrenal masses are uncommon in newborns. The differential diagnosis includes be nign masses (adrenal hemorrhage, extralobar pulmonary sequestration) and malignant ones (neuro blastoma) that may be a finding during an obstetric ultrasound. The use of complementary imaging methods allows a better diagnosis approach during the postnatal period, with implications for the management of these patients. Read More

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http://dx.doi.org/10.32641/rchped.v90i3.823DOI Listing
June 2019
10 Reads